Healthcare Provider Details

I. General information

NPI: 1295737500
Provider Name (Legal Business Name): SPAGE M YEE M.D.
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 06/01/2005
Last Update Date: 12/30/2008
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

330 CENTERVILLE ROAD
LANCASTER PA
17601-1326
US

IV. Provider business mailing address

330 CENTERVILLE ROAD
LANCASTER PA
17601-1326
US

V. Phone/Fax

Practice location:
  • Phone: 717-207-0166
  • Fax: 717-509-3535
Mailing address:
  • Phone: 717-207-0166
  • Fax: 717-509-3535

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207W00000X
TaxonomyOphthalmology Physician
License NumberMD069909L
License Number StatePA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: